Dignity Direct Homecare Limited

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We identified a breach of regulations. Care plans identified and reflected individual preferences, wishes and the support people needed. However, some people’s care and support plans did not reflect accurate information and sufficient guidance for staff to deliver safe care. Some people and their relatives told us, they had no access to their care and support plan. Staff were positive about how the service was run and the support they received from the office staff. Although, the provider conducted relatives’ satisfaction survey feedback responses were positive, during this assessment, people and relatives gave us a mixed feedback about their satisfaction with the care and support they received.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives gave mixed feedback about their satisfaction levels with the care and support provided by staff one relative told us, “In the last 2 months, the regular staff member took 2 weeks leave and I have to say we have been very disappointed with the cover [staff member] they sent. Not at all the type of care that my [loved one] is used to. Just popping their [staff] head round the door and accepting my [loved one’s] I’m alright as a signal to leave without giving my loved one any food or drink.” Another relative commented, “It was agreed that the staff would cook my [loved one] a meal and I have been out and bought the food they [staff] recommended to cook in the microwave, but I am finding more and more food hasn’t even been cooked and is still in the freezer." Notwithstanding the above, one person commented, A relative said, “The carers have recently picked up an emerging pressure sore on my [loved one] bottom and as the District Nurse is already coming in there is quite a lot of liaising going on.” Another relative told us, “The carers do pressure sore checks as my [loved one] sits a lot of the time for long periods of time.”

Staff took a very task centred approach when delivering care to people. For example, one member of staff said, “The care plan tells you what tasks to complete at each call.” Another member of staff told us, “I read care plans, they tell us the tasks we need to carry out.” Other than the general tasks required for the person such as encouragement, prompts, and reminder for medication they were unable to articulate specific needs, risks for people or how they provided person centred care. People’s care plans were not person-centred and mainly task focused. Care plans lacked detailed guidance on how people should be supported appropriately. Therefore, people were at risk of receiving care that was not appropriate to their needs. The language used was often a list of instructions. For example, in one person’s care plan, it stated, “staff to use Sara steady” and “low sugar and carb diet”, however there was no further information detailing what this meant and the support the person required from staff. Another person’s care plan mentioned, “due to MS unable to communicate, beware of body language” and “bed bound, hoist to be used,” however there was no information detailing the support the person required with this condition and the appropriate moving and handling techniques required by staff when using the hoist. For a third person, their care plan stated, “getting up from bed, needs assistance, uses zimmer frame” with no further guidance provided on the safe practice and risks associated with falls and using mobility equipment. People had specific conditions such as diabetes, behaviours of distress, and swallowing difficulties however, care plans did not contain any guidance specific to these needs and how it affected people’s daily wellbeing. Staff completed daily records to show what support they provided to each person. However, some of these records were not legible to demonstrate what support staff had provided to people in line with their care plans.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

One relative said, “We had a care plan which looked like it had been copied out from last year and there are jobs not being done by staff, so we have some issues.”

The branch manager told us they conducted spot checks at people’s home and a feedback survey in August 2023. Survey records showed feedback from people and relatives was positive.

The provider maintained a complaints log which showed any concerns raised the branch manager investigated and responded to in a timely manner. There were systems and processes in place to manage and follow up on accidents and incidents. However, there was no analysis completed to identify any trends or patterns for lessons learnt and discussion with staff to minimise the risk of reoccurrence of such incidents and embed good practice within the service.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.